Bilateral Femoral Subtrochanteric Insufficiency Fractures after Long-term Bisphosphonate Therapy

Park, Jung-Gwan; Song, Kwang-Sup; Jung, Hosung; Lee, Jae-Sung; Lee, Tae-Jin; Kim, Kiseong

doi:10.4055/jkoa.2010.45.2.146

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…In 2005, Odvina et al 8) found a lack of bone formation and a delay of bone union in an iliac crest examination of nine cases for which patients were prescribed long-term treatment with alendronate and experienced abnormal stress fractures. In another study, Park et al 9) reported stress fractures of the subtrochanteric femurs on both sides after long-term exposure to alendronate. Furthermore, the subtrochanteric femurs were found to be most often fractured by relatively high energy damage.…”

Section: Discussionmentioning

confidence: 97%

Bilateral Femoral Neck Insufficiency Fractures after Use of a Long-term Anti-resorptive Drug Therapy for Osteoporosis: A Case Report

Ahn¹,

Kim²,

Lee³

et al. 2015

Hip & Pelvis

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A 78-year-old woman developed an insufficiency fracture on her right femoral neck without trauma after four years of treatment with a bisphosphonate. Her fracture was fixed by two screws and her anti-osteoporotic drug was changed from an anti-resorptive to an anabolic agent. Seven months later, however, she sustained similar insufficiency fracture on the left femoral neck and was treated with the same method. She developed right inguinal pain again approximately eight months after her right side operation. The results of imaging tests revealed that her insufficiency fracture was converted to complete fracture, and that the fracture gap had widened as well. Her right hip was revised with hemiarthroplasty. A histological exam of the fracture site revealed evidence of decreased bone healing. Long-term administration of anti-resorptive drug prevents bone healing and remodeling and can result in atypical fractures of the femoral neck. Osteosynthesis was difficult to accomplish despite the application of proactive fixation. Therefore, more rigid fixation and careful postoperative treatment should be considered.

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Section: Discussionmentioning

confidence: 97%

Bilateral Femoral Neck Insufficiency Fractures after Use of a Long-term Anti-resorptive Drug Therapy for Osteoporosis: A Case Report

Ahn¹,

Kim²,

Lee³

et al. 2015

Hip & Pelvis

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“…단순 방사선 검사상에서 국소적 인 외측 피질골의 비후 소견 및 내측 피질골의 부리 모양 골절, 분쇄골절의 형태를 띠지 않는 양상, 횡상 골절 등을 관찰할 수 있었다 (Fig. 3) 8, 14,18) . 이들 중에서 횡상 골절 및 내측 피질골의 부리 모양의 골절, 분쇄골절이 없는 경우 등은 Puah와 Tan …”

Section: 하지만 이러한 작용이 때로는 문제를 야기시키기도 한 다 골 재형성을 억제하는 과정은 골의 균열을 효과적으로unclassified

Treatment and Prognosis of Femoral Insufficiency Fracture Associated with Prolonged Bisphosphonate Use

Park

Gong

et al. 2014

J Korean Fract Soc

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Purpose: This study was conducted to investigate and identify an appropriate fracture treatment method by analyzing patients in whom a femoral incompetence fracture occurred after receiving a long-term bisphosphonate administration. Materials and Methods:The subjects of this study were 13 cases out of ten patients among those who had a history of receiving bisphosphonate for more than five years and had a fracture or an imminent fracture with a characteristic radiological finding in the femoral subtrochanteric region and the interfemoral region. The period of the drug administration, bone density, the existence of a prodromal symptom, and bilateral fracture were investigated. Results: In seven out of the 13 cases, the patients complained of painat the femoral and pelvic parts as a prodrome (53.8%), and three of them showed a bilateral fracture (30%). An imminent fracture with a prodrome was observed in six cases (46.2%); for three of these cases, a prophylactic fixture pexis was performed by inserting a metal nail into the medullary cavity, and in two out of these three, a complete fracture was found within 11 months on average (3 to 19 months). In the three prophylactic fixture pexis performed cases, no postoperative complications were found, and a radiological finding of concrescence was seen within one year after the operation. Among the nine operation performed cases after the fracture, non-union was found in two. Conclusion: In the patients who have received bisphosphonate for a long periodof time, a prodome may be a useful indicator of a fracture in the femoral subtrochanteric region and the interfemoral region; therefore, a careful observation is necessary. A prophylactic internal fixation is recommended for patients with imminent fracture with a prodome since they have a high risk of a complete fracture is high in them.

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Bilateral Femoral Subtrochanteric Insufficiency Fractures after Long-term Bisphosphonate Therapy

Cited by 2 publications

References 19 publications

Bilateral Femoral Neck Insufficiency Fractures after Use of a Long-term Anti-resorptive Drug Therapy for Osteoporosis: A Case Report

Bilateral Femoral Neck Insufficiency Fractures after Use of a Long-term Anti-resorptive Drug Therapy for Osteoporosis: A Case Report

Treatment and Prognosis of Femoral Insufficiency Fracture Associated with Prolonged Bisphosphonate Use

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